Restorative dentist Dr Veronica Morris reveals her clinic’s multidisciplinary approach to helping patients overcome their anxiety that, for one patient, is all ‘done with heart’.
Despite being a first-world nation with access to advancing technologies and extensive dental health knowledge, it’s concerning that over half of the UK population fails to attend regular dental visits (mydentist, 2022). Also, alarmingly, one-third of British adults suffer from untreated tooth decay.
However, it is essential to acknowledge that visiting the dentist can evoke anxiety in many people, whether due to past traumatic experiences or inherent fears. The UK government’s Adult Oral Health Survey 2021: Service Use and Barriers to Accessing Care used the Modified Dental Anxiety Scale (MDAS) to measure dental anxiety among people with natural teeth before the first COVID-19 lockdown in March 2020 (OHID, 2024).
Published in January 2024, participants were asked to rate their anxiety in various dental situations on a scale from ‘not anxious’ to ‘extremely anxious’. The results showed that 46% had low or no anxiety (scores 5-9), 42% had moderate anxiety (scores 10-18), and 12% had extreme anxiety (scores 19 or above).
Situations causing the most anxiety were having a tooth drilled (28%) and receiving a local anaesthetic injection (25%).
Tailored experience
Before owning my practice, I had a strong vision for the sort of clinic I wanted. When I launched Smile NW Dental Practice 20 years ago, I wanted to bring Harley Street-style dental care to northwest London and encourage patients to attend regular examinations and hygiene appointments. Our aim has always been to prevent the need for future treatments, and since 2004, we have developed a reputation that attracts patients from across the capital.
Patients are individuals, so we focus on designing a treatment experience tailored to specific needs. It’s a multidisciplinary practice that includes an orthodontist, a periodontist, a maxillofacial surgeon, a dentist specialising in endodontics and a dentist practising facial aesthetics, as well as three hygienists and a dental therapist. We also work with an anaesthetist who provides sedation for nervous patients.
Opening at weekends allows us to cater for those who cannot come during the week. One of our dentists and our orthodontist are often available on Sundays. We gained recognition as a forward-thinking practice early on and were nominated at the Private Dentistry Awards for Best New Practice the year we opened.
My team fully understands the significance of addressing patient concerns, fears and anxieties. A significant part of our tailored patient journey is ensuring it is a comfortable experience, and I am proud to lead this initiative.
The elephant in the room
The first step in helping any nervous patient is to address the ‘elephant in the room’ and discover what created their negative feeling about dentistry. Understanding the root cause of any anxiety is crucial to a positive experience and excellent outcomes. So, we listen to them to identify triggers, whether it’s the clinical setting or specific procedures. Often, it lies in a previous bad experience when they were a child, or they might suffer from needle phobia.
I ascertain the basics, such as if they can sit in the chair for an examination – I have had patients who cannot face entering the clinical room. I talk with them in the waiting area to see whether they can tolerate an examination with a mirror. If they can and they require treatment, we offer them sedation or hypnotherapy. I also use The Wand to administer local anaesthetic. Having discussed all options, we allow patients to choose the way forward that best suits them.
Benefits of sedation
Patients who receive sedation are usually much easier to treat, and the procedure is carried out more efficiently and quickly. Sedation dentistry, administered by our experienced anaesthetist, Dr Sonia George, has been instrumental in easing many of our patients’ fears. Sonia has been administering dental sedation for more than 30 years, and her expertise ensures a safe and effective experience for patients with varying levels of anxiety. Older patients recall experiences from years ago, such as the smell of the mask with gas being put over their face for a general anaesthetic, the old-fashioned drills that were on pulleys that vibrated, or treatment without local anaesthetic. This is often at the heart of their phobia.
Latterly, I find fewer patients require sedation because the younger generation has not had these bad experiences. However, while the number of nervous patients may have decreased over the years, this service remains crucial for those requiring additional support. Hypnotherapy is also an excellent adjunct and should be used more for phobic patients. We refer to Dr Mandy Kent, a very experienced dentist and dental hypnotherapist.
Digital scanning
Over the years, we have integrated many advancements into our practice to enhance the patient experience and help those who need it overcome their anxieties. New technology continues to shape the future of dental care, particularly in restorative procedures, and advanced tools like intraoral scanners have revolutionised how we diagnose and treat patients.
Our digital scanner has made our workflows more efficient and offers patients improved comfort and we no longer use impression material. Scanning the mouth has revolutionised restorative dentistry. It is not only used as a record and would be very useful medicolegally, but it has also made it much more comfortable for patients. It is also helpful for visually explaining the state of the mouth and treatment options.
The Wand
The Wand from Dental Sky is another miracle piece of technology that elevates patient comfort and allays common fears. A computer-assisted system, it administers local anaesthesia (LA) via a pen-like device. It is pain-free and excellent for needle phobics. It also allows the delivery of LA to target a single tooth, and children love it as they do not realise they are having an injection. The lips and tongue are not numb, so that patients can eat immediately after their appointment. Carrying out an ID block is also more accurate and effective as the needle does not bend. Quite simply, I cannot do without this piece of equipment now.
Building and sustaining a multidisciplinary practice like Smile NW Dental Practice undoubtedly has its share of obstacles; operating a small business demands dedication and effort. Yet, we continue elevating standards by learning from past mistakes and strategically investing in state-of-the-art technology.
As one kind patient commented in a glowing Google review: ‘I am a very nervous patient, riddled with my own irrational fears, and I can’t thank Dr Veronica Morris and team enough for their incredible kindness and adaptability to cater for this, making me feel safe, calm and confident in their care. So, alongside great dentistry work, it is done with heart.’
Making significant investments in the practice to ensure the safe and comfortable delivery of all our dental treatments certainly reaps rewards.
